Date of Award
Department of Computer Science
Audit logs perform critical functions in electronic health record (EHR) systems. They provide a chronological record of all operations performed in an EHR, allowing health care organizations to track EHR usage, hold system users accountable for their interactions with patient records, detect anomalous and potentially malicious behavior in the system, protect patient privacy, and develop insight into workflows and interactions among system users. However, several problems exist with the way that current state-of-the-art EHR technology handles audit data. Specifically, current systems complicate the collection and analysis of audit logs because they lack an interoperable audit log structure, spread audit log data from different EHR applications across multiple data repositories, and often fail to record all useful information about events in the EHR. Permissioned blockchain technology offers two opportunities to mitigate these issues. First, smart contracts running on the blockchain can impose an interoperable structure on audit log data, both within single health care organizations and across all organizations participating in the network. Second, the blockchain ledger constitutes a consolidated repository for all audit log data at each organization, simplifying the collection of data for analysis. AuditChain, the prototype system I present in this thesis, leverages Hyperleger Fabric's permissioned blockchain technology to address these issues of audit log interoperability, content, structure, and consolidation. Specifically, AuditChain uses the blockchain ledger and smart contracts to standardize audit log content, simplify access to audit log data, and ensure that audit logs contain all necessary and useful information.
Anderson, Jessie, "Securing, Standardizing, and Simplifying Electronic Health Record Audit Logs Through Permissioned Blockchain Technology" (2018). Dartmouth College Undergraduate Theses. 135.